MATERNOFETAL OUTCOME IN MECONIUM STAINED LIQUOR AT TERTIARY CARE HOSPITAL

2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-
Keyword(s):  
Caesarean Section ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Induced Hypertension

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.

scholarly journals Clinico-radiological Observations in Meconium Aspiration Syndrome

2018 ◽  
Vol 56 (209) ◽  
pp. 510-515 ◽  
Author(s):  
Susana Lama ◽  
Shyam Kumar Mahato ◽  
Nagendra Chaudhary ◽  
Nikhil Agrawal ◽  
Santosh Pathak ◽  
...  
Keyword(s):  
Apgar Score ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Radiological Findings ◽  
Female Ratio ◽  
Meconium Aspiration ◽  
Significant Difference

Introduction: To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal. Methods: An observational study carried out for a year in 2014-15 in all babies with MAS. Clinical and radiological profiles of MAS in relation to gender, gestational age, mode of delivery, birth weight, Apgar score, thickness of meconium, age at admission and the immediate outcome were studied. Results: Out of 584 admitted newborns (male=389; female=186) during the study period, 78 (13.4%) had meconium aspiration syndrome with male: female ratio of 1.2:1. Majority of babies admitted to NICU had thick meconium [n=52 (66.7%)]. There was no statistical significant difference in various parameters such as Apgar score at 1 and 5 minutes, respiratory distress, birth asphyxia, duration of oxygen use, MAS severity and chest x-ray in those with thick MAS compared to thin. Among all newborns with MAS, 59% (n=46) had abnormal radiological findings with over two-folds in those with thick MAS (71.7%)] compared to thin (28%). Hyperinflation (47.8%), diffuse patchy infiltration (37%), consolidation (21.7%) collapse (8.7%), right lung fissure (6.5%) and pneumothorax (8.7%) were the abnormal radiological findings seen in MAS babies. The odds of having APGAR score at 1 minute at least 7 or more was twice unlikely in those having thick meconium compared to thin (P=0.02) Conclusions: Thick meconium is relatively common with more significant abnormal radiological findings and low Apgar score.

scholarly journals Clinical Profile of Neonates with Perinatal Asphyxia in a Tertiary Care Hospital of Central Nepal

2014 ◽  
Vol 52 (196) ◽  
pp. 1005-1009
Author(s):  
Sweta Kumari Gupta ◽  
Bhawani Kanta Sarmah ◽  
Damodar Tiwari ◽  
Amshu Shakya ◽  
Dipendra Khatiwada
Keyword(s):  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Clinical Information ◽  
Clinical Problem ◽  
Presentation Mode ◽  
Care Hospital ◽  
Central Nepal ◽  
Bag And Mask Ventilation

Introduction: Birth asphyxia is a serious clinical problem worldwide. It claims approximately 9 million deaths each year. It can lead to serious neurological sequaele, such as cerebral palsy, mental retardation, and epilepsy. Methods: All babies admitted in College of Medical Sciences Teaching Hospital, Chiwan, Nepal, NICU from January 2013 to December 2013 with a diagnosis of birth asphyxia (5 min Apgar<7 or those with no spontaneous respirations after birth) were included in the study (n=125). This was a descriptive observational study. Clinical information was collected (gravida, hour at presentation, mode of delivery, sex of baby, gestational age of the baby, requirement of resuscitation). Neonates were admitted to NICU, observed for complications and managed as per hospital protocol. Results: Among the 722 neonates admitted to NICU, 125 had perinatal asphyxia (17.3%). Babies with Hypoxic ischemic encephalopathy(HIE) Grade I had a very good outcome but HIE III was associated with a poor outcome. Outborn neonates had higher grades of perinatal asphyxia as compared to inborns (p=0.018). Term gestation, Males and Multigravida were associated with a higher rate of birth asphyxia. 22.4% neonates were delivered via caesarean section and 74.4% required bag and mask ventilation at birth. Conclusions: Birth asphyxia was one of the commonest causes of admission NICU. Babies with HIE Grade III had a very poor prognosis. Outborn neonates with birth asphyxia had a higher mortality. Males were frequently affected than females.  Keywords: birth asphyxia; HIE; mortality; measurement.

scholarly journals Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3605
Author(s):  
Richa Rathoria ◽  
Ekansh Rathoria ◽  
Utkarsh Bansal ◽  
Madhulika Mishra ◽  
Ila Jalote ◽  
...  
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Fetal Bradycardia ◽  
Induced Hypertension ◽  
Meconium Stained Amniotic Fluid

Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (<7) at 1 minute and 5-minute, higher incidence of birth asphyxia, Meconium Aspiration Syndrome and increased NICU admission as compared to that among controls.Conclusions: Meconium stained amniotic fluid is more commonly associated with higher gestational age >40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death.

scholarly journals An Analysis of Five years Neonatal Mortality in NICU of a Tertiary Care Hospital of Rawalpindi 2014-2019

2020 ◽  
Vol 24 (4) ◽  
pp. 328-333
Author(s):  
Rai Muhammad Asghar ◽  
Muddasir Sharif ◽  
Khalid Saheel ◽  
Rai Rijjal Ashraf ◽  
Abid Hussain
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Mortality ◽  
Neonatal Jaundice ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Female Ratio ◽  
Meconium Aspiration

Objective: This study was done to find out the main causes and magnitude of neonatal mortality in the neonatal intensive care unit (NICU) of Benazir Bhutto Hospital, Rawalpindi over a period of five years.Material and Methods: A hospital-based cross-sectional study was done from June 2014 to July 2019. The registration book of admitted neonates was reviewed by using a checklist to collect data. Data was analyzed in SPSS 24 for descriptive and bi-variate analysis applying the chi-square test and presented in text, frequencies, tables, and percentages.Results: The study assessed a total of 24,459 neonates admitted to the NICU at Benazir Bhutto Hospital over a span of five years (June 2014 to July 2019). The mean birth weight was 2432 grams ± 740 g (range: Between 800 and 6000 g). Male neonates accounted for 59.8% with male to female ratio of 1.5:1. 67.5% male neonates and 32.5% female neonates expired. Overall 19,832 neonates (81.1%) were discharged, while 4636 (18.9%) died, making a Neonatal Mortality Rate of 18.9% (189 per 1000 admissions). 86.21% of these deaths were early neonatal that occurred in the first week of life. The causes of death were pre-maturity/ low birth weight (LBW), suspected sepsis, birth asphyxia, neonatal jaundice, and meconium aspiration syndrome, accounting for 32%, 31%, 30%, 4%, and 3% respectively.Conclusion: In our NICU the neonatal mortality is high with prematurity/low birth weight (LBW), birth asphyxia (BA), neonatal jaundice (NNJ), and meconium aspiration syndrome (MAS) accounting for most of the deaths. These deaths are largely preventable with better antenatal, perinatal, and neonatal care.

FUNDUS CHANGES IN PATIENTS WITH PREGNANCY INDUCED HYPERTENSION AND ITS ASSOCIATION WITH FETAL OUTCOME IN WESTERN INDIA

2021 ◽  
pp. 15-18
Author(s):  
Saxena Devendra A ◽  
Makhija Sneha C
Keyword(s):  
Birth Weight ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Fetal Outcome ◽  
Western India ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Neonatal Care Unit ◽  
Reliable Marker

Aim: To study the association between fundus changes in patients with pregnancy induced hypertension and the fetal outcome. A prospective cohort study was conducted on 50 patients with PIH at Methods: a tertiary care hospital in Gujarat, India. Retinal status was evaluated under mydriasis in the antepartum and postpartum period. Fetal outcome was recorded in the form of gestational age at birth, birth weight, live/stillborn, mode of delivery, need for induction of delivery and need for admission to neonatal care unit. In this study, PIH induced Results: fundus changes were seen in 48% of the patients. 17(34%) of the fetus were stillborn and 12 of the live born required hospital admission. Mothers of 13(44.82%) of these 29 fetuses with adverse outcome had PIH retinopathy. 14(50%) of the 28 mothers with fetus with low birth weight had abnormal fundi. Serous detachment occurred in 10% of the patients all of which had severe PIH or eclampsia, were primigravida and delivered preterm. Serous detachment resolved over 7-10 days postpartum. Presence of PIH Conclusion: retinopathy may be used as an indicator for predicting the fetal outcome in patients of PIH. It is a particularly reliable marker for preterm delivery when serous detachment occurs in primigravida women with severe PIH or eclampsia.

scholarly journals Morbidity Pattern and Hospital Outcome of Neonates Admitted in Tertiary Care Hospital, Nepal

2020 ◽  
Vol 40 (2) ◽  
pp. 107-113
Author(s):  
Deepeshwara Nepal ◽  
Sumit Agrawal ◽  
Sushan Shrestha ◽  
Ajit Rayamajhi
Keyword(s):  
Birth Weight ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Extremely Low Birth Weight ◽  
P Value ◽  
Care Hospital ◽  
Hospital Outcome ◽  
Poor Outcome

Introduction: The first 28 days of life, neonatal period is crucial as neonates are susceptible to sepsis, birth asphyxia, hypoxic injuries and its consequences which may lead to lifelong morbidity. Knowing the causes of morbidity and mortality is an essential step to improve neonatal health. The aim of this study is to describe the pattern and causes of neonatal admission, immediate hospital outcome in the form of improved, died or left against medical advice  and factors associated with its outcome. Methods: This was a retrospective hospital based study carried out in Neonatal Intensive Care Unit (NICU) of Kanti Children’s Hospital, Kathmandu, Nepal over a period of six months (February 2019 to July 2019 AD). Neonatal details including age, sex, gestational age, birth weight, and maternal age and parity, mode of delivery, place of delivery, neonatal morbidities and neonatal outcomes were recorded in a predesigned performa. Results were expressed as mean, percentage and p value. P- value was calculated by using chi-square test. Results: A total of 163 neonates were admitted during the study period, among which 106 (65%) were males. The mean birth weight was 2483.96 ± 812.63 gm. Among admitted newborns 130 (79.8%) had good outcome, babies born to young mothers (< 20 years of age) had poor outcome which is statistically significant with p value of 0.002. Neonates whose birth weight were < 1000 gram had significantly poor outcome (0.001). Conclusion: Common causes of NICU admission were neonatal sepsis, neonatal hyperbilirubinemia, prematurity and perinatal asphyxia. Babies born to young primipara mothers, extremely low birth weight, extremely premature babies and babies undergoing mechanical ventilation had poor outcome.

scholarly journals Etiology and frequency of respiratory distress in neonates: A cross sectional study conducted in tertiary care hospital, Lahore.

2019 ◽  
Vol 26 (11) ◽  
pp. 1815-1819
Author(s):  
Mirza Liaqat Ali ◽  
Naila Jabbar ◽  
Abdul Hannan ◽  
Azher
Keyword(s):  
Respiratory Distress ◽  
Gestational Age ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Cross Sectional Study ◽  
Meconium Aspiration Syndrome ◽  
Care Hospital ◽  
Cross Sectional ◽  
Meconium Aspiration ◽  
New Born

Respiratory distress in neonate defines as when rate of respiration is greater than sixty in one minute, nasal flaring, grunting and intercostal / sub coastal recession is present. Various causes are reported of respiratory distress in new born. Objectives: To determine frequency of respiratory distress in new born and to Find frequency of various etiologies of respiratory distress in full term newborn admitted up to the age of 24 hours of birth in Study Design: Cross sectional studies. Setting: Neonatal unit of Jinnah Hospital Lahore. Period: From February 10, 2016 till August 10, 2016. Material and Method: SPSS v-20 was used for analysis of data like name, age, sex, gestational age, maternal record of pregnancy and fetus for etiologies of respiratory distress. Results: There were 100(66.7%) male and 50(33.3%) females in this study. The mean gestational age of these newborn was 39.51±1.51 weeks. Respiratory distress was seen in 16(10.7%) of the cases. Transient tachypnea seen in 4(25%) of the cases, Meconium aspiration syndrome was diagnosed in 2(12.5%), Pneumothorax in 3(18.8%), Congenital pneumonia in 2 (12.5%), Sepsis in 6(37.5%) and Birth asphyxia 2 (12.5%) of early neonatal age were the common observed causes. Conclusion: Respiratory distress was 1/10 of the cases. The commonest etiologies were Sepsis preceding to Respiratory distress syndrome, MAS (Meconium Aspiration Syndrome), TTN (Transient Tacyhpnea of Newborn), Pneumothorax, Congenital pneumonia, Birth asphyxia.

scholarly journals Audit of Neonatal Morbidity and Mortality in A Tertiary Care Hospital, Sylhet

2017 ◽  
Vol 15 (2) ◽  
pp. 45-48
Author(s):  
Farzana Hamid ◽  
Syed Moosa MA Quaium ◽  
Azizur Rahman ◽  
AT Reza Ahmad ◽  
Shahariar Khan ◽  
...  
Keyword(s):  
Tertiary Care Hospital ◽  
Perinatal Asphyxia ◽  
Perinatal Care ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Neonatal Unit ◽  
Care Hospital ◽  
Disease Pattern

Background: To know the disease pattern and causes of morbidity & mortality of patients admitted to the neonatal unit in a tertiary care hospital in Sylhet, Bangladesh.Methods: This retrospective study was conducted in the neonatal unit from December 2014 to November 2015. Data of all the patients admitted to the neonatal unit during study period was analyzed for, age, sex, weight, gestational age, place and mode of delivery, maternal antenatal events, disease pattern and their outcome.Results: A total of 985 patients were admitted during study period. Among 985 cases 566(57.5%) were male and 419(42.5%) were female. 450(45.6%) were admitted at the age of less than 24 hours. 122 (12.4%) were preterm babies. 202(20.5%) were low birth weight. 693(70.4%) were delivered in hospital. Main causes of admission were perinatal asphyxia 398(40.4%), neonatal sepsis164 (16.6%), preterm LBW 122(12.4%), Meconium Stained Baby (MSB) 88(8.9%), Intrauterine Growth Retardation (IUGR) 80(8.1%), neonatal jaundice 62(6.2%), Infant of Diabetic Mother (IDM) 30(3.0%), Transient Tachypnoea of Newborn (TTN) 15(1.5%), Meconium Aspiration Syndrome (MAS) 10(1.1%), Respiratory Distress Syndrome (RDS) 6(0.6%) and congenital anomaly 10(1.1%). Most of the deaths were associated with preterm LBW (6.5%), perinatal asphyxia with Hypoxic Ischaemic Encephalopathy (HIE) (4.5%), sepsis (2.4%), RDS (16.7%), MAS (10%).Conclusion: Preterm LBW, perinatal asphyxia and neonatal sepsis were the three leading cause of neonatal morbidity & mortality. These findings could be important in identifying the areas requiring attention to improve the perinatal care and also to manage the problems associated with them.Chatt Maa Shi Hosp Med Coll J; Vol.15 (2); Jul 2016; Page 45-48

scholarly journals MODE OF DELIVERY AND ITS IMPACT ON NEONATAL OUTCOMES IN PRETERM INFANTS

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e27-e27
Author(s):  
Sarah McKnight ◽  
Bishal Gautam ◽  
Michael Miller ◽  
Bryan S Richardson ◽  
Orlando da Silva
Keyword(s):  
Caesarean Section ◽  
Preterm Infants ◽  
Periventricular Leukomalacia ◽  
Ductus Arteriosus ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Breech Presentation ◽  
Neonatal Outcomes ◽  
Care Hospital ◽  
Significant Difference

Abstract BACKGROUND The optimal mode of delivery for preterm infants remains controversial, and routine Caesarean sections (C/S) are not recommended, except for maternal indications. Nonetheless, many preterm infants are delivered by C/S, particularly those in breech presentation, and recent retrospective data have suggested that these infants may have improved outcomes. OBJECTIVES To examine whether C/S as the mode of preterm delivery is associated with decreased mortality and improved short term outcomes. DESIGN/METHODS This retrospective, population-based cohort study examined infants with a gestational age between 23 0/7 weeks and 32 6/7 weeks, born between January 1, 2007 and December 31, 2016, and admitted to the Neonatal Intensive Care Unit at a single Canadian Tertiary Care hospital. Infants with major congenital anomalies were excluded. Data were abstracted from the local Neonatal-Perinatal database for all infants. Two groups, those delivered vaginally and those delivered by C/S, were compared for major neonatal outcomes including the primary outcomes of death and severe intraventricular hemorrhage (IVH), defined as grade 3 or higher. RESULTS A total of 1442 infants met inclusion criteria (784 born by C/S and 658 vaginally). There was no significant difference in neonatal mortality (7.0% vs 7.1%, p=0.925) or severe IVH (6.1% vs 7.4%, p=0.317). There was, however, a significant difference in the incidence of IVH, any grade (19.9% vs 27.5%, p=0.001), which remained after controlling for other significant predictors. There were no other significant differences in the secondary outcomes examined including need for extensive resuscitation, respiratory distress syndrome, bronchopulmonary dysplasia, patent ductus arteriosus, necrotizing enterocolitis, periventricular leukomalacia, or retinopathy of prematurity. CONCLUSION Caesarean section was not associated with decreased mortality in preterm infants, relative to vaginal births. Caesarean section was associated with a reduced rate of IVH (any grade) and there was a trend towards decreased severe IVH which may warrant further study.

scholarly journals Effect of maternal high body mass index on outcome of pregnancy in women with recurrent miscarriages

2021 ◽  
Vol 8 (4) ◽  
pp. 237-241
Author(s):  
Malangori Parande ◽  
Tanvi V Wagh ◽  
Anjali V Wagh ◽  
Nandkumar Salunke
Keyword(s):  
Gestational Diabetes ◽  
Preterm Delivery ◽  
Maternal Obesity ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
Care Hospital ◽  
Pregnancy Induced Hypertension ◽  
Recurrent Miscarriages ◽  
Induced Hypertension ◽  
Maternal Overweight

The epidemic of obesity is spreading worldwide and subsequently, rate of obesity during pregnancy has also increased. Maternal overweight and obesity are widely associated with adverse pregnancy outcomes. Recurrent miscarriage is an important reproductive health issue, because it affects many couples. So the present study is planned to study the relationship between maternal obesity and pregnancy outcome in women with recurrent miscarriages. Observational Cross sectional study was conducted in a tertiary care hospital. 111 Postnatal women between 18 to 44 years of age with history of two or more miscarriages less than 20 weeks of gestation in previous pregnancy were included in the study. First trimester weight at the first visit (registration) was recorded, BMI was calculated & women were divided into obese and non obese groups. The outcome of present pregnancy was noted as Mode of delivery, Gestational diabetes mellitus, Pregnancy induced hypertension, Preterm delivery etc. Statistical tests were used to quantify the risk. Gestational diabetes (OR= 13.6) and pregnancy induced hypertension (OR=4.2) were significantly associated with obesity in women with recurrent miscarriages. [At 95% CI] The incidence of LSCS and preterm delivery was more in overweight and obese mothers, though not statistically significant. Maternal obesity significantly contributes to poor prognosis for the mother and the baby during delivery. Hence the women of this group should be regarded as ‘high risk’ and counselling and the risk assessment should be done during ANC visits.

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